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Anterior segment imaging is a diagnostic procedure aimed at assessing the health and integrity of the cornea, iris, and other structures located in the anterior segment of the eye. Specifically, CPT® Code 92286 refers to anterior segment imaging that incorporates specular microscopy and endothelial cell analysis. The cornea, which is a transparent layer at the front of the eye, consists of multiple layers, including the epithelium, stroma, and the single-celled endothelial layer, which is the innermost layer. The endothelial layer plays a crucial role in maintaining visual clarity by regulating the fluid balance within the cornea. It prevents aqueous humor from infiltrating the cornea and actively pumps excess fluid from the corneal stroma into the anterior chamber, thereby keeping the cornea in a dehydrated state essential for its transparency. However, endothelial cells are unique in that they do not replicate. If these cells are damaged due to disease or surgical intervention, the remaining cells must spread to cover a larger area, which can lead to a decrease in overall cell density. As the number of endothelial cells diminishes, the ability of the endothelial layer to maintain the cornea's dehydrated state is compromised, resulting in corneal cloudiness and a subsequent loss of visual acuity. Specular microscopy is a specialized imaging technique that provides a highly magnified view of a small area of corneal endothelial cells, allowing for detailed evaluation of cell density and configuration. The images captured through this method are typically recorded on videotape or photographic film, enabling comparison with previous images to document any changes in the endothelial layer over time. This procedure is essential for monitoring corneal health and guiding clinical decisions regarding patient care.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 92286 is indicated for the evaluation of various conditions affecting the anterior segment of the eye, particularly those that may impact the cornea and its endothelial layer. The following are specific indications for performing anterior segment imaging with specular microscopy and endothelial cell analysis:
The procedure for CPT® Code 92286 involves several key steps to ensure accurate imaging and analysis of the anterior segment structures, particularly the cornea. The following outlines the procedural steps:
After the completion of the anterior segment imaging procedure, the patient may be monitored briefly to ensure there are no immediate adverse reactions to the anesthetic drops used. Typically, there are no significant post-procedure restrictions, and patients can resume normal activities shortly after the examination. However, it is advisable for patients to avoid rubbing their eyes or exposing them to irritants for a short period following the procedure. The results of the imaging will be discussed with the patient during a follow-up appointment, where further management or treatment options may be considered based on the findings.
| Short Descr | ANT SGM IMG I&R SPECLR MIC | Medium Descr | ANT SGM IMAGING I&R SPECLR MICROSCOPY&NDTHL ALYS | Long Descr | Anterior segment imaging with interpretation and report; with specular microscopy and endothelial cell analysis | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 7 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic ophthalmology services apply... | Bilateral Surgery (50) | 2 - 150% payment adjustment does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | STV-Packaged Codes | Type of Service (TOS) | Q - Vision Items or Services | Berenson-Eggers TOS (BETOS) | M5C - Specialist - ophthalmology | MUE | 1 | CCS Clinical Classification | 220 - Ophthalmologic and otologic diagnosis and treatment |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | GA | Waiver of liability statement issued as required by payer policy, individual case | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | GC | This service has been performed in part by a resident under the direction of a teaching physician | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | CR | Catastrophe/disaster related | LT | Left side (used to identify procedures performed on the left side of the body) | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 24 | Unrelated evaluation and management service by the same physician or other qualified health care professional during a postoperative period: the physician or other qualified health care professional may need to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) unrelated to the original procedure. this circumstance may be reported by adding modifier 24 to the appropriate level of e/m service. | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | QJ | Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b) | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 2024-01-01 | Changed | Short and Medium Descriptions changed. |
| 2013-01-01 | Changed | Description Changed |
| Pre-1990 | Added | Code added. |
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